ANAPHYLAXIS. ANAPHYLAXIS . The first documented case of anaphylaxis was in 2641 B . C . , when Pharaoh Menes of Egypt died from a Wasp sting. While the first fatal reaction to peanuts was described by a Canadian researcher Dr Evans in 1988 .
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Penicillins, β-lactams, tetracyclines, sulfas, vaccines, immunotherapy
Latex, hymenopteravenoms, heterologous sera,
Shellfish, peanuts, and tree nuts
ADMINISTRATION OFintramuscular ADRENALINEIntramuscular injection of epinephrine intothe tigh – more effective than injection intothe arm or subcutaneous administration
• PracticeParameterUpdate - US
• UK Consensus Panel on emergency Guidelines and
International consensus guidelines for emergency
Everyone with rapid progression of symptoms
ESTABLISH AIRWAY and supplemental O2
• I.V. fluids
• Pulmonarysymptoms: Albuterol by nebulization or MDI
• Deterioration of pulmonarysymptoms : Racemicepinephrine by nebulization; Considerintubationortracheostomy
Antihistamines: H1 + H2 blockers
1 mg/kg PO/ IM/ IV (kids)
1.5 mg/kg IM/IV up to 50 mg (kids)
– 1-2 mg/kg prednisone PO
– 1-2 mg/kg methylpredisolone IV (max 250 mg)
Kemp SF, et al. Anaphylaxis. A review of 266 cases. Arch Intern Med 1995; 155:1749–54.
Pumphrey RSH, et al. The clinical spectrum of anaphylaxis in northwest England. Clin Exp Allergy 1996; 26:1364–1370.
Bock SA. Prospective appraisal of complaints of adverse reactions to foods in children during the first 3 years of life. Pediatrics 1987;79:683–688.
Anaphylaxis Committee, AAAAI. Anaphylaxis. Teaching Slides. 2000.
sensitive to one or more insect venoms
Keep EpiPen or EpiPen Jr on hand at all times
Educate and train on EpiPen use
Develop emergency action plan
Wear a MedicAlert bracelet
Consult an allergist to determine need for venom immunotherapy
Allergists can identify specific causes by: